Periodontal Phenotype Thickening Using Sticky Bone and Platelet-Rich Fibrin: A Case Report

Periodontal phenotype thickening is essential in periodontal and peri-implant plastic surgery, since thin phenotypes are strongly associated with increased risk of gingival recession, marginal bone loss, and reduced long-term stability. While connective tissue grafts have traditionally been regarded as the gold standard, they present significant limitations related to donor site morbidity and surgical complexity. Biologically active autologous biomaterials such as platelet-rich fibrin (PRF) and sticky bone have recently emerged as promising minimally invasive alternatives. We report a case of a 50-year-old systemically healthy female patient with a thin periodontal phenotype in the anterior mandibular region. A regenerative approach was performed using particulate xenograft mixed with liquid PRF to create sticky bone, complemented by an advanced PRF membrane placed as a biological matrix, followed by primary closure. Clinical evaluation at nine months demonstrated substantial periodontal phenotype thickening, increased keratinized tissue volume, preservation of alveolar ridge contour, and stable integration of the graft without complications. The patient reported minimal postoperative discomfort and exhibited excellent functional and esthetic outcomes. This case highlights the effectiveness of PRF combined with sticky bone as a biologically driven, predictable, and less invasive strategy for periodontal phenotype modification, offering enhanced tissue integration, reduced morbidity, and long-term stability compared to conventional grafting techniques.